Your guide to birth control: How to find the best option that works for you

We have more birth control options than ever before (thanks, science!)—an awesome thing when it comes to preventing unwanted pregnancy and sexually transmitted infections (STIs). Given the stakes, it’s something everyone could use a primer on.

But with so many effective options readily available, where do you start? We’ll get into what each method does and how to use it; but first, a word on effectiveness.

Perfect use vs. typical use

Most of the stats you see on how well a birth control method works refer to “perfect use” or “theoretical use.” That means that in clinical trials with lab-controlled participants, that’s how effective the birth control method would be at preventing pregnancy.

But that’s not necessarily how it works in real life, says Dr. Colleen Krajewski, or Dr. K., assistant professor at the University of Pittsburgh in Pennsylvania and medical advisor to Bedsider.org, an online birth control support network operated by the National Campaign to Prevent Teen and Unplanned Pregnancy. “There’s no [sense in] discussing perfect use in clinical practice,” she says. “Typical use” stats are the ones to pay attention to—these are how effective experts estimate a given birth control method is IRL.

Part of a birth control method’s effectiveness is in your control. For example, learning the proper way to use a condom—and then making sure to follow the right steps every single time.

But sometimes it’s out of your control. “There are a lot of reasons that birth control methods can fail,” says Dr. K. Learn what can impact the pill’s effectiveness.

The bottom line? Pay attention to stats about actual effectiveness and make sure to take the proper precautions accordingly.

Because it protects against STIs as well as pregnancy, “you can pretty much add a condom to anything—except another condom,” says Dr. K, as the increased friction can increase the risk of tears. Note: If you opt for lambskin condoms due to a latex allergy, keep in mind that they aren’t as effective at preventing STIs.

Female condoms can be used just like male condoms. If you’re a heterosexual woman, they can offer more autonomy—in other words, you won’t have to rely on the guy to pack protection and be using protection properly.

Shaped like a spongy little button with a string attached, the sponge physically blocks the cervix and also kills sperm. You can have sex multiple times while it’s in (up to 30 hours), unlike condoms, which have to be new every time.

Under the current health care law, insurers are required to cover prescription birth control—in other words, you shouldn’t have to pay anything. (Make sure to double-check with your provider.) Without insurance, it could cost anywhere from $10–$113 per month.

If cost is a barrier, explore low-cost prescription options and pharmacy savings clubs via large retailers such as Target, Walgreens, and Walmart. There are many birth control pill options available; your prescriber may be able to adjust the prescription to a lower-cost, but similar, combination.

Because it works by impacting your body’s hormone cycles, the pill needs to be taken at the same time every day for it to work. Oral contraceptive pills may provide other benefits, such as improving acne or easing painful periods.

The emergency contraception (EC) pill, aka the “morning-after” pill, is like a super-concentrated version of the pill that blocks a pregnancy before it can start. “It’s an over-the-counter medication that’s very safe—it’s not a bad idea to keep it in your medicine cabinet just in case,” says Dr. K.

The IUD is a tiny T-shaped device inserted into the uterus by a health care provider. It prevents pregnancy by disabling sperms’ ability to swim. There are two main types of IUDs: copper (no hormones) and progesterone (a hormone that keeps your ovaries from releasing eggs, like the pill, and helps block sperm from getting into the uterus). With the latter, you may experience lighter or even no periods.

Since the IUD doesn’t pump hormones into your body (progesterone stays in the uterus), it’s a good option if you’ve experienced bad side effects from the pill. “I’d [recommend] it for anybody that wants to prioritize pregnancy prevention,” says Dr. K. Depending on which kind you get, the IUD will prevent pregnancy for 3–12 years.

The ring is a flexible little circle you insert into your vagina—sort of like slipping in a tampon—which gives off hormones that prevent the ovaries from releasing eggs and thickens cervical mucus to help prevent sperm from entering the uterus.

If you struggle to remember to take your birth control, or don’t want to have to think about your birth control every day, the shot is a great alternative. One caveat: It does have potential side effects associated with weight gain. “If you’re someone who struggles with your weight and with your appetite, the shot is probably not for you,” says Dr. K.

Emily Ike, MS recently graduated from Teachers College-Columbia University in Community Health Education, with a focus in sexuality education and sexual health. She currently works in college health and wellness promotion.